1234 PHYSIOLOGY 



paired interrenal bodies lying on the front of the spinal column, and the medulla by a 

 number of collections of chromaffine cells lying in close juxtaposition to the spinal net 

 In some animals accessory suprarenals are not infrequent in which both cortex and 

 medulla may be represented. In all animals we find masses of tissue, the so-called 

 paraganglia, in close association with the sympathetic system, which present the chro- 

 maffine reaction typical of the medulla. Since a watery extract or decoction of these 

 bodies has the same influence on injection into the blood stream as an infusion of the 

 medulla of the suprarenal body itself, we are probably justified in regarding these bodies 

 as equivalent to accessory medullary portions of the suprarenal. They have the same 

 origin, the same staining reactions, and the same physiological effect as the latter. 



The functions of the suprarenal bodies were a matter of pure hypothesis 

 before Addison in 1855 drew attention to the coincidence of degenerative 

 destruction of these bodies with a disease which has been known since that 

 time as Addison's disease. The three cardinal symptoms of this disorder 

 are (1) bronzing of the skin, (2) vomiting, (3) excessive muscular weakness 

 and prostration. The disease is almost invariably fatal. Addison's observa- 

 tions have been amply confirmed since that time, but we are not yet in a 

 position to account for the occurrence of all these symptoms as a result of 

 interference with the cortex and medulla of the suprarenals. The experi- 

 mental destruction or extirpation of these bodies has naturally been 

 frequently carried out. The operation always leads to the death of the 

 animal within twelve to twenty -four hours. Even when the destruction is 

 carried out by degrees it has been impossible to reproduce the bronzing 

 which is so characteristic of Addison's disease. The one symptom which 

 is observed as a result of the experimental extirpation is the excessive pros- 

 tration, which is attended with muscular weakness and a lowered blood 

 pressure. In a few cases it has been found possible to keep rats alive ait<-r 

 total extirpation of these organs, but this result is probably due to the 

 frequent presence in these animals of accessory suprarenals. 



Schafer and Oliver in 1894 found that a watery extract or decoction of 

 the suprarenal bodies, when injected into the circulation, caused a very great 

 rise of blood pressure, brought about chiefly by constriction of all the blood 

 vessels of the body. The active substance responsible for this rise was 

 limited entirely to the medulla, infusions of the cortex being without influence 

 on the blood pressure. Later on Takamine succeeded in isolating the active 

 substance, to which he gave the name of adrenaline, and since that time 

 physiological chemists have succeeded not only in determining the consti- 

 tution of adrenaline but also in preparing it synthetically. The constitution 

 of adrenaline is shown by the following formula : 



HO 

 HO/ \ CH(OH) CHjNHCH-j 



Since it possesses an asymmetric carbon atom, a substance of this formula 

 may be either Ia3vo- or dextrorotatory. Both forms, as well as the racemic 

 modification, have been prepared synthetically. The substance which 

 occurs in the suprarenal gland is the leevorotatory modification, and Cushny 

 has shown that it is only this modification which is active, injection of the 



